Income and job satisfaction fall among US doctors

The income of US doctors in most specialties fell from 2010 to 2011, while their unhappiness with practising medicine rose, according a survey conducted by Medscape, the internet medical site.

The specialties with the highest income were radiology, orthopaedic surgery, and cardiology, while the lowest were internal medicine, family medicine, and paediatrics.
Just half (54%) of the more than 24 000 respondents in 25 specialties said that they would choose medicine again as a career.

Doctors’ average income did not vary greatly by region. It was lowest in the north east of the US at $204 000 a year (£125 000; €154 000) and highest in the north central region at $234 000 a year.

Income differed greatly according to whether doctors had board certification, where they have passed exams for specialty registration. Doctors with board certification earned $236 000, whereas those without earned $125 000.

US doctors’ income comes from different sources. Doctors may work in academic settings (such as research, the military, or government), for healthcare organisations, for hospitals, in multispecialty group practices, in single specialty group practices, as solo practitioners, or in outpatient clinics. Doctors may be an employee, an independent contractor, an owner of a solo practice, or a partner in a practice. Those who were practice partners earned the most ($308 000).

Only about half the doctors believed that they were fairly compensated for their work, and 15% or less (depending on specialty) considered themselves “rich.”

Men earned about 40% more than women overall, although the gap was smallest in the primary care specialties of internal medicine, family medicine, and paediatrics.

Doctors were concerned about their falling incomes, and some resented that other specialties made more money. They also said that the demands of increased regulation and documentation took the joy out of medicine.

The Medscape survey also asked US doctors about their workload and their job satisfaction. Paperwork and administrative work took 1-4 hours a week for half the doctors, but a third spent more than 10 hours a week and 13% spent more than 25 hours a week on these tasks.

Most commonly, doctors spent 30-40 hours a week seeing patients, although there was wide variation. Patients’ visits lasted 9-20 minutes in most cases.

When asked how they would behave if they had to make career decisions “all over again,” half (54%) of respondents said they would choose medicine as a career again, down from more than two thirds (69%) in 2011. Only 41% said they would choose the same specialty and 23% said they would choose the same practice setting.

Doctors who worked in dermatology were most satisfied with their career, whereas those who worked in plastic surgery were least satisfied. Almost half the specialties surveyed scored under 50% in overall satisfaction.